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“Plastic and Reconstructive Surgery Outreach Mentorship to sharpen skills in CHUK catchment Area”

Much has been done five years ago putting in place Plastic Surgery Sub-Specialty

The Plastic and Reconstructive surgery is reality in Rwanda. Since, 2015, much has been done to start, sustain and extend the range of services offered by this specialty in CHUK.

In partnership with the University of Rwanda and Operation Smile, the department of Surgery established plastic surgery unit in CHUK to improve access to timely, safe and affordable surgical care for the patients in need of surgical care amenable to plastic surgery sub-specialty.

As elsewhere in Africa, the “burden of surgical disease amenable to plastic surgery” in Rwanda is largely due to trauma and burns, infections, obstetric complications, malignancies, congenital anomalies and few cosmetic procedures.

Surgeons ready for outreach plastic surgery

For the last 5 years, great milestones have been achieved: Plastic surgery unit at CHUK is now an accredited training site for the College of Surgeons of East, Central and Southern Africa(COSECSA) in plastic surgery. Furthermore, it reached out to move forward the population, treating them nearby home in different outreach and mentorship programs.

Professor Faustin Ntirenganya, Senior consultant general & plastic surgeon specialist at CHUK, also leading the department of surgery at the University of Rwanda, here explains that it takes an extra mile to train and have a motivated and highly qualified team of nurses, anesthesiologists and other supportive staff as that of CHUK to be able to conduct safely plastic surgery procedures in remote hospitals. This is beneficial not only for patients who get surgical care nearby home, but also for our plastic surgery residents

Currently 3 doctors are doing their fellowship in plastic surgery, rotating between Rwanda Military Hospital and CHUK. Indeed, having exposure to different types of pathologies improves their exposure and help them to innovate.
Transferring knowledge and skills in the local teams has an additional value to introduce surgery in CHUK Catchment area.

Plastic surgery team in Ruhengeri Hospital
(Illustration of the back excision and reconstruction and Bilateral reduction mammoplasty)

Despite COVID-19 outbreak, this important activity continued aiming to decrease
considerable the long list of patients waiting surgery and/or consultation. Recently, 3 outreach plastic surgery missions have been organized in Kibungo, Kabutare and Ruhengeri hospitals where about 150 patients have been operated and more than 500 consulted. It is planned that this program will be extended to Bushenge and Kibuye Hospital soon.

In those outreach programs, the majority of patients who benefited from plastic and
reconstructive surgery have post burn complications and post burn contractures, cancers and other plastic surgery pathologies.

“Common observation is that there is a huge unmet needs for plastic and reconstructive surgery in all the hospital we have visited” said Prof Faustin Ntirenganya.

Surgery in general is understaffed with very limited staff in nursing and surgical
specialists; a very challenging situation when one wants to transfer knowledge and skills.

Furthermore, much have to be done in terms of infrastructures upgrading, equipment consumables and ICU capacity.

CHUK plastic surgery outreach and mentorship program received a positive feedback
from the population and patients. Different patients expressed their gratitude gratitude to the health sector in general, CHUK, Operation Smile and the University of Rwanda in particular.

Plastic surgery team in Kabutare and Kibungo Hospitals

Among others testimonies to appreciate the treatment benefited from outreach
plastic surgery Uwimana Edith from Nyamasheke , Nirembere Emmanuel from Nyabihu, Imanizabayo Theogene from Rutsiro and Nyirabakire Pelagie , Mutuyimana Angelique from Musanze have been heard on different community radio stations expressing their satisfaction and appreciation of this program.

Sustaining the best practices while building capacity is the concern of consultant
surgeons in plastic surgery. As innovative and complementary practice, the outreach
plastic surgery program supported by different surgical camps is another home-grown solution to deal with big numbers of patients. In the same line, classic training curriculum is boosted by such pragmatism approaches. It calls up creativity, innovation and getting out comfort zone but at the end, it creates a very good teaching and learning experience, as well as a very good long-term mentorship strategy.

By Pascal Mbuguje